Pediatric Skin Conditions

Most skin rashes that occur during childhood are not a reason for significant concern, as they usually improve spontaneously without any treatment. However, there are some instances when further investigation and treatment is required.

Diaper Dermatitis

Diaper dermatitis or rash is a group of skin conditions that involve inflammation of the skin in the diaper area. There are several causes of the characteristic skin rash including:

• Contact with irritants
• Candida albicans yeast overgrowth
• Contact with allergens
• Inflammatory skin conditions such as seborrheic dermatitis

Irritant contact dermatitis occurs when the skin comes into contact with any irritant, such as urine or feces, for a long period of time. It causes a red rash on the skin which may become swollen and may be associated with the appearance of blisters.

Candida albicans is a type of yeast that is naturally present on the skin in the groin area. However, it can become overgrown in the warm, moist environment inside a diaper and lead to a yeast infection. It presents as bright red bumps or patches on the skin, which may also show the formation of pus.

Allergic dermatitis occurs when there is an allergic reaction to any of the components of a diaper, such as the adhesive tape or elastic. It causes a red and swollen rash in the particular area that is in contact with the allergen.

Eczema

Also known as atopic dermatitis, eczema is a chronic skin condition that often presents in childhood. It causes dry, red itchy patches of skin, which may ooze when scratched. Eczema can worsen if the skin comes into contact with irritants.

Atopic dermatitis is associated with allergies, and commonly affects children who have a family history of eczema, asthma and allergies. It is usually managed with the use of topical steroid creams and oral antihistamine medications.

Psoriasis

Psoriasis is a chronic skin condition that leads to red, flaky patches of skin with a layer of scales overlying them. Some affected children with mild changes may not require treatment, whereas others will need ongoing and long-term treatment to manage the condition.

Warts

Warts commonly affect children, and present as hard bumps on the hands and feet. They occur due to contact with a virus, such as human papillomavirus (HPV). The management of warts is local, and targets the affected skin only. There are no specific antiviral treatments available.

Cellulitis

Cellulitis is an infection of the skin and underlying tissue, which leads to reddening and swelling of the skin, which may become hot and painful. It can occur anywhere on the body and may require antibiotic treatment.

Impetigo

Impetigo, also known as school sores, is a skin infection that causes sores and blisters. These may be bullous or non-bullous. It is particularly common in young school children.

Ringworm

Ringworm is a specific fungal infection that causes a red or silver ring to appear on the skin, which may become inflamed or scaly. It usually affects the limbs, although it may occur over any area of the body.

Scabies

Scabies is a skin condition that is caused by the burrowing of tiny mites in the skin. It is very itchy. It is usually passed on through prolonged or repeated skin contact between an infected child and another.

Slapped Cheek Syndrome

Slapped cheek syndrome is a common infectious rash occurring in young children. It causes a bright red rash on both cheeks of the face. When the rash appears, the infection is no longer contagious and the child may go to school.

Erythema Multiforme

Erythema multiform is usually a mild skin rash that results from an allergic reaction to the herpes simplex virus (HSV). Distinctive spots with a dark-red center surrounded by a paler ring, that appear on the hands, feet, limbs and torso, are characteristic of the condition.

Molluscum Contagiosum

Molluscum contagiosum is a viral skin infection that is characterized by the appearance of small, firm spots on the skin that develop in clusters. It is usually passed on from one child to another through physical contact.

Pityriasis Rosia

Pityriasis rosea is a skin condition that causes itchy, red, scaly patches to develop, which commonly affects children and young adults.

Acne

Acne is very common in adolescence, and is caused by fluctuations in the hormonal levels of children as they go through puberty. Acne occurs when the hair follicles or pores become blocked with sebum or keratin. It can become worse if children have an unhealthy diet, poor hygiene or high levels of stress. The blocked pore can become red and swollen, and may secrete pus.

Other Infections

There are various infections that commonly affect children that can cause a skin rash.

• Hand, foot and mouth disease: this causes ulcers in the mouth and blisters on the hands and feet of affected children.
• Chickenpox: a rash forms all over the body, composed of itchy red spots that form blisters. These quickly crust over and become scabs that eventually drop off.
• Measles: here there are reddish-brown blotches on the head, neck and other areas of the body. It is now rare in developed countries due to the widespread use of the measles-mumps-rubella (MMR) vaccine.
• Scarlet fever: this is a bacterial infection that causes a pink rash that is rough to the touch.

References

• http://my.clevelandclinic.org/childrens-hospital/health-info/diseases-conditions/hic-Taking-Care-of-Childrens-Skin-Problems
• http://reference.medscape.com/features/slideshow/skin-conditions-infancy
• http://www.ncbi.nlm.nih.gov/pmc/articles/PMC449820/
• http://dermatologytimes.modernmedicine.com/dermatology-times/news/challenges-treating-pediatric-skin-conditions
• http://www.nhs.uk/conditions/skin-rash-children/Pages/Introduction.aspx

Further Reading

• All Dermatology Content
• What is Dermatology?
• Dermatologic Therapy
• Dermatologist Education and Training
• Curettage (Dermatology)

Written by

Yolanda Smith

Yolanda graduated with a Bachelor of Pharmacy at the University of South Australia and has experience working in both Australia and Italy. She is passionate about how medicine, diet and lifestyle affect our health and enjoys helping people understand this. In her spare time she loves to explore the world and learn about new cultures and languages.